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evelrctl <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print clearly W}th Ink <br />PRESS HARD YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON PERMIT NO. r <br />e.POLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY:�- <br />HEREBY APPLIES FOR PERMISSION <br />AT THE FOLLOWING LOCATION <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: 5.9-8rD <br />11 'q11a,Pwt 1 ev 6/ i'll 3- <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEWER <br />DRAINAGE <br />WATER <br />STREET <br />DEPARTMcNT APPROVALS <br />COMMUNICATIONS <br />TRAFFIC <br />PLANNING <br />APPROVED FOR CONSTRUCTION DATE <br />APPROVED AS CONSTRUCTED DATE <br />1, <br />INITIAL INSPECTION REQUESTED <br />DRIVEWAY SECTION <br />AIL <br />rap" T -_L30" <br />The undersigned owner hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damages, costs. <br />expenses. or causes of action that may arise because of installation <br />and maintenance of the Improvement or other right-of-way use <br />hereto applied for and tunnel agrees to remove same upon notice <br />from the City and to replace public properly damaged thereby. <br />7 <br />sic NAT E OF APPLICANT <br />''l <br />ADDRESS <br />CITY ZIP <br />?S.J aLIS ASS i��s <br />TELEPHONE M1'U\1BER ALTERNATE <br />DAT <br />